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Organization
PEACH STATE PEDIATRICS
Active
Organization
PEACH STATE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED WARIS MD (OWNER)
(850) 270-9249
Entity
Organization
Contact information
Practice address
3001 S COBB DR SE, SUITE 107, SMYRNA, GA 30080-7874
(850) 875-3600
Mailing address
3001 S COBB DR SE, SUITE 107, SMYRNA, GA 30080-7874
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
62300
GA
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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